Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Palliative Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
4040 HOSPITAL WEST DR, AUSTELL, GA 30106-8117
(770) 732-6798
(770) 732-6732
Mailing address
4040 HOSPITAL WEST DR, AUSTELL, GA 30106-8117
(770) 732-6798
(770) 732-6732
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
GA
Other
Enumeration date
05/24/2011
Last updated
11/18/2013
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